94004 Vent mgmt nf per day
What 94004 is
CMS fee schedule short descriptor: Vent mgmt nf per day.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 94004 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.00 | 0.24 | 0.07 | 1.31 | $43.76 |
| Facility (hospital, ASC) | 1.00 | 0.24 | 0.07 | 1.31 | $43.76 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 94004 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 94004? These codes are bundled into it
94004 is a Column 1 code in 6 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
94375 | Respiratory flow volume loop | 0 - no modifier bypass | Check pair |
94450 | Breathing response hypoxia | 0 - no modifier bypass | Check pair |
94660 | Cpap initiation&mgmt | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
94004 is bundled into these codes
94004 appears as a Column 2 code in 464 active edits. Reported with one of these Column 1 codes on the same date of service, 94004 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
00100 | Anes px salivary gland w/bx | 1 | Check pair |
00102 | Anes px plstc rpr cleft lip | 1 | Check pair |
00103 | Anes rcnstv px eyelid | 1 | Check pair |
00104 | Anes electroconvulsive ther | 1 | Check pair |
00120 | Anes px ear w/bx nos | 1 | Check pair |
00124 | Anes px ear otoscopy | 1 | Check pair |
00126 | Anes px ear tympanotomy | 1 | Check pair |
00140 | Anes procedures on eye nos | 1 | Check pair |
00142 | Anes px on eye lens surgery | 1 | Check pair |
00144 | Anes px eye corneal trnspl | 1 | Check pair |
00145 | Anes px eye vitreortnl surg | 1 | Check pair |
00147 | Anes px on eye iridectomy | 1 | Check pair |
00148 | Anes px eye ophthalmoscopy | 1 | Check pair |
00160 | Anes px nose&sinus nos | 1 | Check pair |
00162 | Anes px nose&sinus rad surg | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.